What Are Dental Inlays? And How Do You Know If You Need One?
When it comes to restoring teeth, most people are familiar with fillings and crowns. But what about something in between? That’s where dental inlays come in—a conservative, highly durable solution for repairing moderately damaged or decayed teeth.
The Anatomy of a Tooth
To understand this, it’s beneficial to understand
the structure of a tooth. Teeth are composed of
several layers:
- Enamel: The hard, outer surface that protects the tooth. It is the first line of defense against decay and damage.
- Dentin: The layer beneath the enamel, which is less dense but provides additional support to the tooth structure.
- Pulp: The innermost part, containing nerves and blood vessels. This is the vital part of the tooth that, when infected, can cause significant discomfort and requires intervention.
What Are Dental Inlays?
A dental inlay is a custom-made restoration used to repair damage to the chewing surface of a tooth—usually the molars or premolars. Unlike a filling, which is molded directly into the cavity during a dental visit, inlays are fabricated outside the mouth (usually in a dental lab) and then bonded into place.
Inlays are typically made of materials like porcelain, composite resin, or gold. Porcelain inlays are especially popular because they’re both strong and can match the natural color of your teeth, making them a great aesthetic and functional choice.
How Are Dental Inlays Different from Fillings or Crowns?
Think of inlays as the middle ground between a filling and a crown:
- Fillings are used for smaller cavities.
- Inlays are used when the cavity is too large for a filling but doesn’t require a full crown.
- Crowns are used when most of the tooth structure is compromised.
While traditional fillings can weaken the structure of a tooth over time (especially if large), inlays are bonded to the tooth and actually help reinforce its strength.
Signs You Might Need a Dental Inlay
1. Large Cavities
If you have a cavity that’s too big for a filling but doesn’t justify a full crown, your dentist might recommend an inlay as a strong, long-lasting alternative.
2. Cracked or Fractured Teeth
Teeth with moderate cracks, especially on the chewing surfaces, may benefit from the support that inlays offer—particularly when dental bonding isn’t sufficient.
3. Old or Failing Fillings
If you have a large, metal filling that’s breaking down or causing the tooth to crack, replacing it with an inlay can restore function while improving aesthetics.
4. Persistent Tooth Pain While Chewing
Pain in a back tooth when chewing may be due to a damaged cusp or decay that hasn’t reached the nerve. If the damage is moderate, an inlay could be the perfect fit.
5. Visible Decay on Dental X-rays
Sometimes, damage isn’t obvious until a dental x-ray reveals deeper decay. If it’s too extensive for a filling but the tooth is mostly intact, an inlay may be recommended.
The Inlay Procedure: What to Expect
Getting an inlay typically requires two visits:
Visit 1: Preparation & Impression
- The dentist removes the damaged portion of the tooth.
- An impression is taken and sent to a lab.
- A temporary filling is placed.
Visit 2: Placement
- The temporary filling is removed.
- The custom inlay is fitted and bonded to the tooth using high-strength dental adhesive.
- The inlay is polished and checked for proper fit and bite.
The result is a restoration that’s strong, smooth, and built to last—often 10–15 years or more with proper care.
Contraindications: When Inlays May Not Be the Best Option
While dental inlays are an excellent restorative choice for many patients, they aren’t suitable for everyone. Certain oral health conditions and habits can compromise the effectiveness and longevity of inlays.
- Poor Oral Hygiene: Inlays require a clean, healthy oral environment to be successful. Patients who struggle with plaque control or gum disease may be at higher risk of secondary decay around the inlay, which can lead to restoration failure.
- Heavy Occlusal Forces (Bruxism): Individuals who grind or clench their teeth—whether during the day or while sleeping—place excessive pressure on their restorations. This can increase the likelihood of fractures or dislodgment, particularly with ceramic or composite inlays.
- Patients Under 16 Years Old: Inlays are generally not recommended for children or adolescents under 16, as their teeth and jaws are still developing. Changes in tooth structure over time may affect how well the inlay fits and functions long term.
- Extensive Tooth Damage: If the tooth structure is too compromised or there’s insufficient remaining tooth to support an inlay, a full crown may be the better choice to ensure durability and proper protection.
Before committing to an inlay, your dentist will evaluate your unique oral health situation to determine the most appropriate treatment. A personalized approach ensures both effectiveness and long-term satisfaction with the results.
Do Inlays Hurt?
Not at all. The procedure is generally done under local anesthesia, and most patients report minimal to no discomfort. After the procedure, there may be mild sensitivity that goes away within a few days.
Maintaining Your Dental Inlay
Dental inlays require the same care as natural teeth:
- Brush twice daily with fluoride toothpaste
- Floss every day
- Schedule regular dental cleanings and exams
- Avoid chewing ice or very hard foods that could damage any dental work
With good oral hygiene, inlays can remain functional and beautiful for many years.
Is an Inlay Right for You?
If you’re dealing with a damaged or decayed tooth but want to avoid a full crown, talk to your dentist about inlays. They’re a conservative yet highly effective option that helps preserve more of your natural tooth structure.
At Strobel Family Dental, we use advanced materials and precision techniques to ensure your inlay looks natural and feels comfortable. We also use detailed dental x-rays to detect problems early, helping us recommend the most appropriate treatment, whether that’s an inlay, dental bonding, or another restoration.
Cost vs. Longevity: What the Research Says
While dental inlays—especially those made from ceramic or gold—are often more expensive upfront than direct composite fillings, it’s important to consider the long-term value. Inlays are typically marketed as more durable and precisely fitted, but long-term studies have shown inconsistent evidence that ceramic or composite inlays have significantly lower failure rates compared to well-placed direct composite fillings. This means that for some patients, a traditional filling may be just as effective and more cost-efficient, particularly in cases where the damage isn’t extensive. Ultimately, the best choice depends on your specific oral health needs, location of the tooth, and budget.
Choosing the Right Dental Inlay Material: Gold vs. Zirconia vs. Ceramic
Gold Inlays
Gold has been used in dentistry for decades and is still considered a premium material for inlays.
Pros:
- Exceptional durability – Gold is extremely strong and can last 20+ years.
- Gentle on opposing teeth – It doesn’t wear down natural enamel.
- Great fit and precision – Gold adapts well to tooth contours for a tight seal.
- Biocompatible – Rarely causes allergies or reactions.
Cons:
- Not tooth-colored – The metallic color is visible, making it less aesthetic for front teeth.
- Higher cost – Gold is a more expensive material.
- May conduct heat/cold – Some patients experience sensitivity.
Best for: Molars and back teeth where strength and longevity are prioritized over appearance.
Zirconia (Zirconium) Inlays
Zirconia is a type of ceramic material known for its strength and biocompatibility. It’s often used in both dental crowns and inlays.
Pros:
- Highly durable – Nearly as strong as metal; very resistant to wear.
- Tooth-colored – Offers better aesthetics than gold (though not as translucent as other ceramics).
- Biocompatible – Safe for most patients, with low risk of allergic reactions.
- Less prone to cracking – Zirconia is very tough under biting pressure.
Cons:
- Harder on opposing teeth – Can wear down natural enamel over time.
- Difficult to adjust – Once fabricated, it’s not as easy to fine-tune.
- Less aesthetic than porcelain – Slightly more opaque, especially in front teeth.
Best for: Patients who want a strong, tooth-colored option for back teeth or who grind their teeth.
Ceramic (Porcelain) Inlays
Ceramic, particularly porcelain, is widely used for patients seeking a natural-looking restoration.
Pros:
- Excellent aesthetics – Matches natural tooth color and translucency very well.
- Stain-resistant – Maintains color over time.
- Biocompatible – Safe and non-reactive for most patients.
- Customizable – Easy to shape and polish for a natural look.
Cons:
- More brittle than gold or zirconia – Can chip or crack under heavy pressure.
- May require more tooth removal – To accommodate thickness of the inlay.
- Shorter lifespan than metal – Typically lasts 10–15 years with proper care.
Best for: Front or visible teeth where aesthetics matter most.
Final Thoughts: Which One Is Right for You?
The right inlay material depends on where the tooth is located, your cosmetic goals, your bite, and budget. For example:
- Choose gold for unmatched durability on molars.
- Choose zirconia if you want tooth-colored strength for back teeth.
- Choose ceramic/porcelain if aesthetics are your top priority, especially for visible areas.
